Frühes Testen Testing for SARS-CoV-2 should be performed as soon as possible following first medical contact, irrespective of treatment strategy, in order to allow HCP to implement adequate protective measures and management pathways.
Vier Risikogruppen Patients should be categorized into 4 risk groups (i.e. very high risk, high risk, intermediate risk, and low risk) and managed accordingly.
Konservativ bei intermediärem Risiko Patients with Troponin rise and no acute clinical signs of instability (ECG changes, recurrence of pain) might be managed with a primarily conservative approach.
CCT Non-invasive imaging using CCTA may speed-up risk stratification, avoid an invasive approach139 allowing early discharge.
Hohes Risiko For patients at high risk, medical strategy aims at stabilization whilst planning an early (< 24 hours) invasive strategy. The time of the invasive strategy may however be longer than 24 hours according to the timing of testing results.
Intermediäres Risiko Patients at intermediate risk should be carefully evaluated taking into consideration alternative diagnoses to T1MI, such as Type II MI, myocarditis, or myocardial injury due to respiratory distress or multiorgan failure or Takotsubo. In the event any of the differential diagnoses seem plausible, a noninvasive strategy should be considered and CCTA should be favored, if equipment and expertise are available.
The European Society for Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease
during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESCCOVID-19-Guidance. (Last update: 10 June 2020)